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GIR Test 3 > B5-065 Pancreatitis > Flashcards

B5-065 Pancreatitis Flashcards

1
Q

treatment for acute pancreatitis caused by gallstones

A
  • fluid
  • anti-emetics
  • pain control
  • GI consult- lap chole
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2
Q

keep patient NPO if they have acute pancreatitis caused by

A

hypertriglyceridemia

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3
Q

treatment for acute pancreatitis caused by hypertriglyceridemia

A

insulin

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4
Q

if acute pancreatitis due to autoimmune disorder is suspected, what lab should be ordered?

A

IG4

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5
Q

treatment of acute pancreatitis due to autoimmune cause

A

steroids

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6
Q

acute pancreatis can be caused by […] procedure

A

ERCP

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7
Q

mid-epigastric pain radiating to back

A

acute pancreatitis

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8
Q

discoloration of tissue on the flanks due to tissue catabolism of hemoglobin

A

turner’s sign

perforation or retroperitoneal bleed

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9
Q

blue discoloration in the periumbilical region due to hemoperitoneum

A

cullen’s sign

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10
Q

best imaging modality for acute pancreatitis

A

CT abdomen with contrast
US if you have hepatobiliary concerns

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11
Q

diagnostic criteria for acute pancreatitis

A
  • acute epigastric pain radiating to back
  • 3x increase in serum lipase or amylase
  • imaging findings consistent with disease

requires 2 of 3

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12
Q

if the dx of acute pancreatitis is established by abdominal pain and serum pancreatic enzymes..

A

CT with contrast not normally required

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13
Q

characterized by absence of organ failure/systemic complications

A

mild acute pancreatitis

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14
Q

characterized by transient organ failure/systemic complications (resolves in 48 hrs)

A

moderately severe acute pancreatitis

AKI

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15
Q

characterized by persistent organ failure that many involve one or more organs persisting greater than 48 hrs

A

severe acute pancreatitis

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16
Q

BISAP score

A
  • BUN > 25
  • Impaired Mental Status
  • SIRS
  • Age > 60
  • Pleural effusion

0-2 points = low mortality, 3-5= high mortality

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17
Q

local complications of acute pancreatitis

3

A
  • interstitial edamatous pancreatitis
  • necrotizing pancreatitis
  • vascular complications and hemorrhage
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18
Q

systemic complications can refer not only to organ failure, but also

A

exacerbation of pre-existing comorbid conditions

CAD, HF, COPD

19
Q

on CECT, pancreatic parenchyma shows a relatively homogenous enhancement. no findings of pancreatic necrosis

A

interstitial edematous pancreatitis

20
Q

5-15% of acute peripacreatic fluid collections persist beyond 4 weeks. at that point they become a

A

psuedocyst

21
Q
  • well defined non-epithelized wall
  • contain no solid material
A

pancreatic pseudocysts

22
Q
  • well circumscribed
  • homogenous fluid density
  • no non-liquid component
  • well defined wall, completely encapsulated
A

pancreatic pseudocyst

23
Q
  • heterogenous
  • no defineable wall
  • lack of pancreatic parenchymal enhancement with contrast
A

acute necrotic collection

24
Q

most common vascular complication of acute pancreatitis

A

venous thrombosis of splenic vein

25
Q

mainstay of pancreatitis treatment

4

A
  • fluids
  • pain management
  • anti-emetics
  • nutrition
26
Q

are antibiotics indicated in the treatment of acute pancreatitis?

A

no
unless evidence of extrahepatic infection

ascending cholangitis, bacteremia, UTI, pneumonia

27
Q

when is enteral feeding indicated?

A

moderate to severe pancreatitis

start with NJ tube, gastro- or jejuno- tube may be necessary for severe

28
Q

nutrition should be addressed within […] hours

A

24-72

unless due to hypertriglyceridemia

29
Q

majority of infection is acute pancreatitis is caused by

4

A

E coli
pseudomonas
klebsiella
enterococcus

30
Q

antibiotics known to penetrate into pancreatic necrosis

A
  • carbapenems
  • fluroquinolones
  • ceftazidime
  • cefepime + metronidazole
31
Q
  • elevated amylase and lipase
  • cross sectional imaging findings of pancreatic edema and mesenteric stranding
A

simple interstitial pancreatitis

32
Q

when should cholecystectomy be performed following pancreatitis?

A

after the abdominal exam has normalized

33
Q
  • improves outcomes
  • fewer readmissions for recurrent pancreatitis
  • decreases overall cost
A

early cholecystectomy

after abdominal exam normalizes

34
Q

best initial treatment for acute pancreatitis

A
  • fluid resuscitation
  • correction of metabolites/electrolytes
  • early enteral nutrition
35
Q

there is no proven benefit to the use of […] in acute pancreatitis

A

antibiotics

36
Q

encapsulated homogenous fluid collection older than 4 weeks

A

pancreatic pseudocyst

37
Q

heterogenous fluid collection would suggest

A

necrotizing pancreatitis

acute necrotic collection, walled off necrosis, etc

38
Q

best treatment for pancreatic pseudocyst

A

open/endoscopic cyst-gastrectomy

39
Q

percutaneous drainage is indicated for

A

fluid collections separate from pancreas

40
Q

necrosectomy is indicated for

A

necrotic pancreas

41
Q

psuedocysts less than […] can be observed as they will resolve

A

6 cm

42
Q

diagnostic imaging modality of choice in acute pancreatitis

A

contrast enhanced CT

43
Q

best treatment for severe pancreatitis with infected fluid

A
  • EUS
  • IV antibiotics
  • possible cystogastromy/necrosectomy

GIR Test 3 (16 decks)

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